Abstract

Introduction Various national strategies and standards in end of life care emphasise that generalists should identify those in the last year of life, and be able to have advance care planning (ACP) discussions with these patients. We identified that local clinician's lack confidence in doing this.

Aim(s) and method(s) Our aim was to increase confidence in discussing advance care planning (ACP). We delivered 3 hour long education sessions to senior doctors and nurses in the hospital and community using role play with actors. The hospital videoed the role play in a dedicated simulation suite. Pre and post course questionnaires on confidence in communication were completed.

Results There were 3 hospital sessions to 9 senior doctors and 8 senior nurses, and 5 community sessions to 31 senior nurses and 11 GPs. Confidence across all domains improved post course. On average those community clinicians who rated their confidence as good or very good rose from 25.5% to 50.7% and the hospital clinicians from 37.4% to 76.7%. The hospital clinicians rated themselves as more confident than community clinicians in 3 questions before the course and in all domains after the course.

Conclusion(s) All clinicians improve their confidence in discussing ACP after the course. On average hospital clinicians were more confident both before and after the course. Different teaching environments may account for some of this but conclusions are limited by the different numbers in each group. Those delivering ACP communication sessions should consider potential differences in confidence between the 2 groups and adapt sessions accordingly.

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